| Code | Description | Claims | Beneficiaries | Total Paid |
| S0215 |
Non-emergency transportation; mileage, per mile |
3,985 |
458 |
$199K |
| S0209 |
Wheelchair van, mileage, per mile |
5,755 |
2,364 |
$173K |
| A0130 |
Non-emergency transportation: wheelchair van |
5,745 |
2,349 |
$131K |
| T2005 |
Non-emergency transportation; stretcher van |
810 |
596 |
$57K |
| A0120 |
Non-emergency transportation: mini-bus, mountain area transports, or other transportation systems |
3,978 |
458 |
$56K |
| T2049 |
Non-emergency transportation; stretcher van, mileage; per mile |
780 |
568 |
$21K |